The first comprehensive understanding of the dangers of lead poisoning in the United States came about in the early 20th century through the pioneering efforts of Dr. Alice Hamilton. Hamilton attended the University of Michigan Medical School in the 1890's at a time when women medical students and physicians were almost unheard of. In 1897, she joined the staff of Hull House, a Chicago settlement house where she supervised a well-baby clinic, researched the causes of typhoid, and rather intrepidly helped investigate the local cocaine traffic. She became increasingly concerned about the devastating health problems that afflicted the poor factory workers, mostly immigrants, who populated the city's West Side. It was not a popular issue.

"When I talked to my medical friends about the strange silence on this subject in American medical magazines and textbooks," she would later write, "I gained the impression that here was a subject tainted with Socialism or with feminine sentimentality for the poor."

Hamilton published an article in 1908 that encouraged the establishment of the Illinois Commission on Occupational Disease, for which she was able to investigate the various lead industries. But there were still no laws protecting workers from injury or disease. In those early days, Hamilton wrote, "I met men who employed foreign-born labor because it was cheap and submissive, and then washed their hands of all responsibility for accidents and sickness in the plant, because, as they would say: 'What can you do with a lot of ignorant Dagoes, Wops, Hunkies, Greasers?' "

The first compensation laws for disabling work-related injuries came into effect in 1910, but, far from reflecting an enlightened corporate attitude, the legislation was sponsored by industries eager to limit their liability.